在新西兰量化未满足的二级医疗需求:使用行政数据进行的多年人口研究
Nicholas Bowden1,2, Jerram Bateman3, Robin Gauld4,5
1Department of Paediatrics and Child Health, University of Otago, Dunedin, New Zealand.
BMJ open
|September 2, 2025
概括
新西兰的专家转诊数量每年都在增加,这表明医疗保健需求不断增加. 这种趋势加剧了健康不平等,特别是在某些社会人口群体和地区,需要紧急的政策干预.
科学领域:
- 医疗服务研究
- 医疗公平研究
- 公共卫生政策
背景情况:
- 拒绝转诊的情况是潜在未满足医疗需求的关键指标.
- 了解拒绝转诊的模式对于识别和解决医疗保健获取差异至关重要.
- 之前的研究表明,UMN可能会对特定的社会人口群体和地区产生不成比例的影响.
研究的目的:
- 检查新西兰首次专家评估 (FSA) 拒绝的趋势.
- 根据社会人口统计学,地区和健康专业分析拒绝转诊的变化.
- 评估拒绝转诊的时间变化作为UMN的标志物.
主要方法:
- 从国家患者流量 (NPF) 收集 (2018-2022) 的行政数据进行了反复的横截面分析.
- 全国数据涵盖了新西兰公共医院专家的所有FSA转诊情况.
- 首要结果分析:在优先考虑时,FSA的转诊率下降.
主要成果:
- 分析了超过290万份FSA,下降率为13.1%.
- 女性的转诊率下降的风险更高 (RR 1. 069).
- 毛利人 (RR 0.817) 和太平洋人 (RR 0.706) 以及年轻/年长的年龄组的衰退风险较低.
- 观察到下降风险的区域和专业差异很大.
- 转诊的总体风险每年增加4. 1% (RR 1. 041).
- 随着时间的推移,所有群体的衰退风险都有所增加,非毛利/非太平洋地区的个人和贫困地区的个人风险更高.
结论:
- 在新西兰,未满足的专业医疗需求显著增加.
- 这些趋势加剧了现有的健康不平等现象,
- 迫切需要采取政策干预措施来解决专业护理的差异,特别是在高风险专业和人群中.
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